Sleeve Gastrectomy alters the normal stomach anatomy resulting in a significant incidence of hiatal hernia and gastroesophageal reflux disease. Although many patients remain asymptomatic, many complain of severe reflux symptoms not responsive to medical management. To describe the diagnosis and treatment of hiatus hernia after sleeve gastrectomy with conversion to Omega Loop Bypass and using fixation suture technique.
Patients with symptomatic hiatus hernia after sleeve gastrectomy proven on Barium meal, CT scan with oral contrast and endoscopy underwent surgical correction of the paraesophageal hernia, including complete reduction of the hernia sac, resection of the sac, hiatal closure followed by conversion to omega loop bypass and fixation suture technique.
Operative intervention led to resolution of symptoms.There were no postoperative complications and at 2-year follow-up, there was no sign of recurrence of the hernia.
Hiatal hernia repair with OLB and fixation suture appears to be safe and effective in the treatment of hiatal hernia after sleeve gastrectomy.